Claims Billing Specialist - Remote

Overview

The Claims Billing Specialist at Privia Health is responsible for the accurate and timely processing of medical claims, managing accounts receivable, and resolving claim issues while collaborating with internal teams and external partners.

In Short

• Manage accounts receivable and analyze aged AR.
• Investigate and resolve denial sources.
• Make independent decisions on claim adjustments and appeals.
• Collaborate with internal teams and care center staff.
• Support large care center go-lives, including potential overnight travel.
• Work with Revenue Optimization team for reimbursement alignment.
• Drive achievement of department KPIs.
• Perform denial analysis using the Trizetto platform.
• Other duties as assigned.

Requirements

• High School Graduate.
• 3+ years of experience in medical billing.
• Experience with medical claims billing in Connecticut preferred.
• Athena EHR experience preferred.
• Understanding of revenue cycle performance drivers.
• Experience with major payers like Anthem and Medicare.
• Advanced skills in Microsoft Excel and Google Sheets preferred.
• Compliance with HIPAA rules and regulations.

Benefits

• Hourly pay range of $24 to $26.45.
• Eligible for an annual bonus targeted at 10%.
• Medical, dental, vision, and life insurance.
• 401K plan.
• Paid time off and wellness programs.